Avella Specialty Pharmacy: Spreading Innovation

Although there are many specialty pharmacies, few can adequately explain how specialty differs from community pharmacy like The Apothecary Shops.

In The Apothecary Shops’ information video, CEO John D. Musil explains what motivated him to start his pharmacy business. His focus was to take the clinical teachings of pharmacy school and put them into practice in an environment that was especially focused on patient care. Musil recognized that specialty pharmacy is a high-touch practice and he wanted to work in a business in which his staff understood this importance of patient care. Musil notes, “The basic core principle is delivering and dispensing excellence.”

He also stresses the significance of leading by example—Musil was once a practicing pharmacist himself. “The hardest transition for me was moving away from the bench, and moving into more of a management type of role where I was running an organization. I take great pride in leading this thriving organization and in serving a larger patient population.”

Musil won an Arizona Corporate Excellence award (ACE) for “CEO of the Year” in 2011 for his efforts with The Apothecary Shops.The Apothecary Shops has provided individualized care and support to patients since 1996, with specific expertise in fertility, women’s health, oncology, ophthalmology, infectious disease, pain management, transplant, veterinary medicine, and compounding—and the company continues to expand.

According to the company’s corporate overview, The Apothecary Shops’ model “eliminates many barriers to access, expedites initiation of therapy, facilitates communication, promotes education, and frees physicians and their staff from time-consuming activities, such as prior authorization processes and financial assistance for patients with these conditions.”

Background
The pharmacy, originally based in Scottsdale, Arizona, now has 16 community-based physical locations to date (in Arizona, California, Nevada, New Mexico, Missouri, Ohio, and Texas) and a Phoenix-based national distribution center. These locations are staffed with pharmacists and certified pharmacy technicians who are specially trained in one or more disease states. These disease states include oncology, fertility, ophthalmology, transplant, women’s health, compounding, pain management, dermatology, rheumatology, infectious disease, and animal health. In 2006, The Apothecary Shops became the first pharmacy in the nation to earn the Pharmacy Compounding Accreditation Board’s (PCAB) Seal of Accreditation. The Apothecary Shops’ staff is experienced in payer policies and procedures, prior-authorization guidelines, and utilization-management programs.

Unique service offerings
The Apothecary Shops provides a continuum of care between the patient and caregiver, provider, and pharmacist. This service provides tools for adherence, patient education, reimbursement counseling, refill reminders, and wellness checks tailored to the specific medication therapy, among other benefits. The Apothecary Shops also has an opt-in text messaging service they use to enhance adherence and to provide their patients with ancillary support.

The wholesale branch also introduced a tool called the GlowCap (manufactured by Vitality) to further assist patients in taking their Gleevec or Tasigna medication on time and on schedule. Even if a patient asks a pharmacist about dosage requirements, it can be hard for a patient to take the medications on time. The GlowCap accounts for human error and provides an additional tool to promote adherence by alerting patients through sound and visual cues that they need to take their medication. GlowCap also alerts the pharmacy if the patient has missed several doses so that the pharmacist can intervene.

With the help of their account managers and over 50 clinical pharmacists on staff, the company is able to effectively process specialty drugs that require prior authorization and works closely with patients to help them get financial assistance with their drugs through organizations like Patient Advocate Foundation’s Co-Pay Relief (CPR) Program, the National Organization for Rare Disorders (NORD), the Chronic Disease Fund (CDF), the Healthwell Foundation, Patient Services Incorporated, and the Leukemia & Lymphoma Society. In 2011, The Apothecary Shops secured $5 million in financial assistance for their patients.

Lastly, The Apothecary Shops partners with LDM in the content and distribution of valuable patient resources and educational materials called CarePoints. These materials help patients mitigate side effects of drug therapies and handle the adverse reactions that can develop throughout the course of treatment. Patients on oral chemotherapy at risk for developing adverse effects such as Hand Foot Syndrome might receive a resource like the one below:

Partnerships and affiliates
The most recent innovation to date from the pharmacy is through their affiliate, The Apothecary Shops Wholesale, which is the wholesale branch of the pharmacy. The company’s wholesale branch earned accreditation from the National Association Boards of Pharmacy in 2011 under its Verified-Accredited Wholesale Distributors program. This partner was approved to distribute Eylea (aflibercept) injection in November 2011 for the treatment of neovascular (wet) age-related macular degeneration (AMD). They have also received exclusive distribution rights for Mitosol for use in glaucoma surgical procedures.

"With over 17 years of ophthalmology practice experience, The Apothecary Shops are among the finest specialty pharmacies in the nation, particularly with regards to ophthalmological medications," said Jim Rehovsky, RPh, vice president, ophthalmology, for The Apothecary Shops.

Through partnerships with pharmaceutical manufacturers, The Apothecary Shops has been granted distribution rights for limited distribution drugs. In total, the company has 33 contracts for limited distribution drugs. Most recently, The Apothecary Shops Specialty Pharmacies received distribution rights from pharmaceutical manufacturer Pfizer for its new drug Inlyta (axitinib) for the treatment of advanced renal cell carcinoma (RCC) after failure of one systemic therapy.

Although The Apothecary Shops has many ventures, specialty pharmacy is the focal point of their business. The community-based pharmacies do not have large areas for retail merchandise, and they only carry products that specifically support their specialty pharmacy clients. They have a an explicitly defined goal: “To link the patient, prescriber, and pharmaceutical partner with specialty pharmacy services that enhance the clinical experience while on therapy and ensure the best possible outcome to manage the disease.” The Apothecary Shops has been extremely successful in this goal so far.